This is a request for a Mentored Patient-Oriented Research Development Award (K23). The overall aim of the proposal is to provide the candidate, Esperanza Diaz MD., with a supervised patient oriented research and educational experience that will enable her to become an independent investigator in mental health services research with focus on the Latino population and cultural issues. Dr. Diaz is an experienced, bilingual, bicultural clinician. A K23 will free her time from clinical duties to obtain the skills and experience of an independent researcher. Dr. Diaz has chosen a distinguished set of mentors Robert Rosenheck MD., Joyce Cramer BS., and Scott W. Woods MD., from Yale University and Janis H. Jenkins Ph.D., from Case Western Reserve University. They are active mental health services and cultural researchers with excellent records of successful mentorships. The first aim of the study is to determine the medication adherence rates and differences in attitudes to medications in patients treated for Schizophrenia and other Psychotic Disorders, Mood disorders, Anxiety Disorders, and Somatoform Disorders in three groups. 1) Latinos treated at a culturally competent Latino Clinic, 2) Latinos treated by non Latinos in a standard Community Mental Health Center and 3) non Latino groups treated at the same Community Mental Health Center. Analysis of the data will be used to identify the role of cultural factors and other attitudes in medication compliance in Latinos to formulate a culturally sensitive intervention for enhancing medication adherence in Latinos. The second aim of the project will compare a previously tested intervention to enhance adherence to medicines, the Medication Usage Skills for Effectiveness, (MUSE) among Latino patients receiving the MUSE intervention alone, Latino patients receiving the MUSE plus a culturally sensitive enhancement and Latino patients receiving a non specific counseling intervention. The control group will provide data on medication adherence and outcome. Dr. Diaz's training experience includes a three year period of intense coursework at the school of Epidemiology and Public Health and at Case Western Reserve University. The plan includes developing skills in Statistics, Biostatistics, Epidemiology, Health Policy, Mental Health Services Research, Analysis of Data, etc., leading to a Masters in Public Health. Dr. Diaz will also develop skills in descriptive and qualitative research, Data collection, Data analysis. Dr. Diaz will have an R01 proposal ready by the end of funding.